The Relationship Between Household Income and Obesity Among Older Adults: Investigating the Moderating Role of Race

Obesity, a leading global health concern, disproportionately impacts older adults. This study explores the relationship between household income and obesity (BMI ≥ 30) among U.S. adults aged 65 and older, using data from the 2020 wave of the Health and Retirement Study (HRS), a nationally representative dataset. Logistic regression models and predictive margins illustrate disparities, with participants categorized into income quartiles and analyzed across three racial/ethnic groups: Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Hispanic. Results show that lower-income older adults face significantly higher obesity rates, with those in the lowest income quartile having 1.72 times greater odds of obesity compared to higher-income individuals. NHBs consistently exhibit the highest obesity prevalence across all income levels, followed by Hispanics, while NHWs report the lowest rates. Even among higher-income NHBs, obesity remains elevated, highlighting the role of structural barriers such as food deserts, healthcare disparities, and chronic stress from systemic racism. The income-obesity relationship differs by race/ethnicity. For NHWs, obesity decreases steadily with higher income, while NHBs show persistently high rates regardless of income, and Hispanics display mixed patterns influenced by cultural and environmental factors. These findings suggest that addressing income disparities alone may not suffice to reduce obesity among minority groups, as systemic inequities persist. Targeted interventions are needed to address these structural barriers. Policies promoting access to healthy food, recreational spaces, and preventive healthcare in underserved minority communities are critical to mitigating obesity disparities in older adults.